Sedation Options for Large Aggressive Dog

Re: Sedation Options for Large Aggressive Dog

mariette asselbergs — Tue, 29 Jan 2013 17:04:11 GMT

We don't have inhalation aneathesia in our mainly large animal practice, so we use dorm/torb/ketamine all the time for all routine ops and surgery for patients on a limited budget who otherwise would be referred to our more specialised and equipped small animal colleagues. But we almost always add rectal diazepam to help muscle relaxation and a calm recovery from the ketamine. (We don't use the expensive rectal tubes but just squish an ampoule rectally, works perfectly).

Mariette

Re: Sedation Options for Large Aggressive Dog

Mark Frost — Mon, 21 Jan 2013 21:52:59 GMT

I too remember papavaretum being used for aggressive dogs in the anaesthesia rotation at uni, but haven't used it since as don't need the extra hassle of using a high schedule CD for those very few occasions its needed. ACP/medetomidine/torb seems to do the job in most cases...

Re: Sedation Options for Large Aggressive Dog

Gerry Henry — Mon, 21 Jan 2013 20:53:14 GMT

Methadone 1ml per 30kgs BW, add domitor at up to 0.025mls/Kg BW, give im, luvverly.

Re: Sedation Options for Large Aggressive Dog

David Mills — Mon, 21 Jan 2013 20:37:05 GMT

Orthopods at college used to love A/D/T - beauty of it is that it allows a lower dose of dom which is cheaper and I think more balanced, and I think it reduces the chances of sudden wake-up that D/T can suffer from.

Re: Sedation Options for Large Aggressive Dog

Busybee — Mon, 21 Jan 2013 20:02:17 GMT

I used Dom, Torb and ACP combo in the end, given SQ and owner sat with dog while she went to 'sleep'. Beautiful sedation, good colour throughout, nice and stable, good xrays obtained and nice smooth recovery.

Re: Sedation Options for Large Aggressive Dog

Rajat — Mon, 21 Jan 2013 16:59:26 GMT

[quote user="Busybee"]

Resurrecting this thread as I have a similar case tomorrow - though is a very overweight (20kg) terrier in for xrays, who gets very worked up ie. not possible to get IV. Would I be right in thinking the doses for:

Dom/Torb/ACP combination are 0.2ml/0.1ml/0.05ml per 10kg

and

Dom/Torb/Ket are 0.4ml/0.1ml/0.1ml per 10kg?

Also, are there any combinations I could use (off license) SQ rather than risking going intra-fat when giving an IM injection?

Many thanks!

ps. we have already tried D+T IM to no effect.

[/quote]

I suggest Dom 20-50ug/kg (0.02-0.05ml/10g) and Torb 0.03 mg/kg or 0.3ml/10kg or better yet morphine 0.3- 0.5mg/kg with ketamine 5mg/kg . I try not to combine dom and acp as one causes vasodilatation and the other vasoconstriction and on a general principle I don't like that..

Ketamine is fabulous stuff to get these patients asleep, as is alfaxan IM, I had to use that recently in a case similar to Andrew's and it worked a treat after all else (semi) failed.

Worth remembering to dose to their lean body weight rather than 'scale' weight if obese, but I'm sure you knew that

I remember anaesthesia dept in college using papavaretum for the hard core aggressive dogs in the hospital. Has anyone used it in practice?

Re: Sedation Options for Large Aggressive Dog

Robin Grimmer — Mon, 21 Jan 2013 11:51:31 GMT

with a fat dog, definitely avoid lumbar area as you'll probably hit fat. Either neck muscles or quads. In this dog I would go in quads, get an assistant to hold the dog's front end securely by looping the slip lead through something solid like a fixed metal ring if you have one, thus immobilising the head.

Re: Sedation Options for Large Aggressive Dog

Michael Woodhouse — Sun, 20 Jan 2013 20:39:12 GMT

Busybee - you want a heavy sedative or a GA?

You'll be sad using those doses.

I'd go 0.3ml/10kg Dom, 0.1ml/10kg Torb and maybe 0.25ml ACP/10kg. No point going too homoeopathic.

If you want GA with the ketamine the dose is:

Dosage and administration: Administer Domitor™ at a dose rate of 0.40 ml/10 kg bodyweight (equivalent to 40 μg medetomidine/kg) and Ketaset at 0.5–0.75 ml/10 kg bodyweight (equivalent to 5.0–7.5 mg ketamine/kg), maybe add torb at 0.1ml/10kg

Neither matter if IM or SC, just takes longer under the skin.

Re: Sedation Options for Large Aggressive Dog

Busybee — Sun, 20 Jan 2013 20:28:20 GMT

Dom/Torb/ACP combination are 0.2ml/0.1ml/0.05ml per 10kg

and

Dom/Torb/Ket are 0.4ml/0.1ml/0.1ml per 10kg?

Also, are there any combinations I could use (off license) SQ rather than risking going intra-fat when giving an IM injection?

Many thanks!

ps. we have already tried D+T IM to no effect.

Re: Sedation Options for Large Aggressive Dog

Oliver Robinson — Sun, 17 Oct 2010 22:44:46 GMT

I think Alfaxan is even licensed I/m in Oz (although possibly just in cats)

Re: Sedation Options for Large Aggressive Dog

Andrew Kent — Sat, 16 Oct 2010 18:57:26 GMT

[quote user="robloxley"]Anyone tried Alfaxan i/m?[/quote]

Yes! I'd heard of its use and gave it a try in an aggressive dog that was still lunging at me after a dom/torb/acp/midazolam combo. Worked an absolute treat within 5 mins. Now having a bit more of a play with it in a few other situations and still very impressed. The downside is the cost compared to dom/torb.

Andy

Re: Sedation Options for Large Aggressive Dog

Vikki Halliday LLB — Thu, 07 Oct 2010 23:01:58 GMT

Apomorphine marvelous stuff!

Far more predictable in onset of vomiting than Xylazine, and causes no sedation.

Much less caustic than washing soda (yes Michael it can cause ulceration as it is alkaline), although have used this in an emergency and it does work, however you do need to get it right to the back of the tongue, which is not so easy in a large agressive dog.

Always now keep apomorphine vials in practice and in home visit/ emergency box

Re: Sedation Options for Large Aggressive Dog

Michael Woodhouse — Thu, 07 Oct 2010 22:46:16 GMT

Not tried apomorphine.

I think there were reports of people using caustic soda and damaging oesophagus. Washing soda is fairly benign.

Re: Sedation Options for Large Aggressive Dog

Andrew Mellor — Thu, 07 Oct 2010 17:55:31 GMT

[quote user="Simon Neuhoff"]

Errr- have you tried Apomorphine? It works a whole lot better than Xylazine and is considerably easier to administer than washing soda!

[/quote]

absolutely agree apomorphine is fabulous and very reliable, seems subcut route most effective as an emetic, i stopped using washing soda after i read a report of it perforating an oesophagus !!!!!!!!!

Re: Sedation Options for Large Aggressive Dog

Simon Neuhoff — Thu, 07 Oct 2010 17:35:25 GMT

Errr- have you tried Apomorphine? It works a whole lot better than Xylazine and is considerably easier to administer than washing soda!

Re: Sedation Options for Large Aggressive Dog

Michael Woodhouse — Thu, 07 Oct 2010 17:16:01 GMT

[quote user="Simon Neuhoff"]Interesting - is this as a sedative when the dog has eaten or as a routine emetic? [/quote]

I suppose the answer is 'both' - but if I want a dog to vomit then I give them Xylazine.

I only use it for home PTS or sedation outside of the surgery because I have it in my car, not because i think it works better in a domestic environment

We have some washing soda but I have not found it especially useful. Some dogs just won't vomit with half a tub.....

Re: Sedation Options for Large Aggressive Dog

Aurelijus vet — Thu, 07 Oct 2010 14:24:20 GMT

Zoletil 50 mg mix with Xylazin 10 ml. 0,25 ml. for 4 kg. body weight sedation about 2 h.

Re: Sedation Options for Large Aggressive Dog

Simon Neuhoff — Thu, 07 Oct 2010 13:41:27 GMT

[quote user="Michael Woodhouse"]

An afterthought - I find dogs more likely to vomit after Xylazine rather than with Domitor and use it for the reason.

[/quote]

Interesting - is this as a sedative when the dog has eaten or as a routine emetic?

Re: Sedation Options for Large Aggressive Dog

Michael Woodhouse — Thu, 07 Oct 2010 12:39:45 GMT

An afterthought - I find dogs more likely to vomit after Xylazine rather than with Domitor and use it for the reason.

Re: Sedation Options for Large Aggressive Dog

Michael Woodhouse — Thu, 07 Oct 2010 12:38:38 GMT

[quote user="Simon Neuhoff"]I haven't used Xylazine in dogs in nearly 10 years now but I seem to remember it working very well in aggressive dogs. Curious that it seemed to be so much less affected by the adernaline.[/quote]

I only ever use it for home PTS or dogs I may have to sedate away from the surgery. I always think I have worked out the dose wrong when 5 or 6ml will flatten a dairy cow weighing three quarters of a tonne then you give 4ml to a fat 40kg lab!

Re: Sedation Options for Large Aggressive Dog

Simon Neuhoff — Thu, 07 Oct 2010 12:20:49 GMT

[quote user="Martin Jones"]

In olden days we might have used a 'bit' of xylazine to effect, followed by a partial reversal whilst converting on thio (read propofol) and inhalation. I always found xylazine to have better juggernaut-stopping powers than dorb.

[/quote]

I haven't used Xylazine in dogs in nearly 10 years now but I seem to remember it working very well in aggressive dogs. Curious that it seemed to be so much less affected by the adernaline.

Re: Sedation Options for Large Aggressive Dog

Yantha Smyth — Thu, 07 Oct 2010 12:08:59 GMT

I have, a couple of times, had a smaller completely psycho dog to deal with that we have successfully knocked out using a regime of oral acp/diazepam given at home 1hr prior, followed by small dose dom and high dose torb IM at the surgery...will hunt down the doses and report back. Worked very well with no stress to dog or staff, and good recovery.

Re: Sedation Options for Large Aggressive Dog

Robert Wilson — Fri, 24 Sep 2010 21:51:18 GMT

Thanks for all the suggestions.... in the end I gave him 2ml Domitor/0.5ml Torbugesic and 0.5ml ketamin i/m. Out like a light!

Excellent recovery 2 hours later following 2ml Antisedan.

Will probably give the Dom/Torb/ACP as per Henry a go at some stage.

Re: Sedation Options for Large Aggressive Dog

Henry Jubb — Fri, 24 Sep 2010 21:11:56 GMT

I would second Andrew Mellor's suggested dose.

I often add ACP to Dom/Torb combinations especially for xrays. I prefer it as I find dogs to be less twitchy this way.

The dose I use I find easy to remember, and generally effective if given IM or IV. Dose in ml is 1/100 of the weight (Kg) for Torb, Double this for Dom and Halve this for ACP

eg, 40kg dog: 0.8ml domitor, 0.4ml Torbugesic, 0.2ml Acp.

(your dog, 54kg: 1.08ml Dom, 0.54ml Torb, 0.27ml ACP)

Then put the dog somewhere quiet for a good 10 - 15 minutes while the full effect is achieved (maybe next to the xray table in this case!).

Reverse with Antisedan is no problem unlike with ketamine.

Re: Sedation Options for Large Aggressive Dog

Andrew Mellor — Fri, 24 Sep 2010 18:23:33 GMT

Hi yes I have used dom,torb, acp combination quite a few times , have to say mainly when tackling dangerous dogs prior to euthanasia, acp seems to really stop that overridding of the dom,torb that can occur when they are really stressed.

If it is a healthy dog otherwise I would probably go for 1ml dom, 0.5ml torb and 0.3acp ( could top this up if necessary) unless really painful you should be able to do most positions for x-ray under this , vd hips just roll slowly and allow dog to relax into position and usually no need for anything else

good luck